Provider Demographics
NPI:1699870634
Name:KALBAC, DANIEL G (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:G
Last Name:KALBAC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 430430
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33243-0430
Mailing Address - Country:US
Mailing Address - Phone:305-661-7601
Mailing Address - Fax:305-661-0154
Practice Address - Street 1:6701 SUNSET DR
Practice Address - Street 2:SUITE 201
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4529
Practice Address - Country:US
Practice Address - Phone:305-661-7601
Practice Address - Fax:305-661-0154
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58988207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME58988OtherWORKERS COMPENSATION
FL000623OtherNEIGHBORHOOD HEALTH PLAN
FL209485OtherAVMED HEALTH PLAN
FL1237594OtherUNITED HEALTHCARE
FL4517471OtherAETNA
FL17697OtherBLUE SHIELD
FL591370925OtherCIGNA
FLF11594Medicare UPIN
FL17697OtherBLUE SHIELD
FL591370925OtherCIGNA